A client has been hospitalized for multiple sclerosis exacerbation and is being given high dose IV glucocorticoid steroid medications. The prescriber places new orders for weight based sliding scale insulin. The patient asks why they need insulin. Are they now diabetic? What is the nurse's best response?
Insulin is commonly given to all hospitalized clients.
You likely developed diabetes prior to hospitalization, but are just now being diagnosed.
You have developed type 1 diabetes and will need insulin for the rest of your life.
Glucocorticoid steroid medications can cause temporary hyperglycemia.
The Correct Answer is D
Choice A reason: This choice is incorrect because insulin is not commonly given to all hospitalized clients. Insulin is a hormone that lowers blood sugar levels in the body. It is only given to clients who have diabetes or other conditions that cause high blood sugar, such as pancreatitis, sepsis, or steroid therapy. The nurse should explain the indication and purpose of insulin to the client and not make false or misleading statements.
Choice B reason: This choice is incorrect because the client did not likely develop diabetes prior to hospitalization, but are just now being diagnosed. Diabetes is a chronic condition where the body either does not produce enough insulin or does not use it properly, resulting in high blood sugar levels. Diabetes can be diagnosed by measuring the blood sugar levels, the hemoglobin A1c levels, or the oral glucose tolerance test. The nurse should not assume or imply that the client has diabetes without proper testing and confirmation.
Choice C reason: This choice is incorrect because the client did not develop type 1 diabetes and will not need insulin for the rest of their life. Type 1 diabetes is an autoimmune condition where the body destroys the insulin-producing cells in the pancreas, leading to a complete lack of insulin. Type 1 diabetes usually develops in childhood or adolescence, and requires lifelong insulin therapy. The nurse should not diagnose or predict the client's condition without evidence or authority.
Choice D reason: This choice is correct because glucocorticoid steroid medications can cause temporary hyperglycemia. Glucocorticoids are anti-inflammatory drugs that suppress the immune system and reduce inflammation. They are used to treat conditions such as multiple sclerosis, asthma, rheumatoid arthritis, and allergic reactions. However, they can also increase the blood sugar levels by stimulating the liver to produce more glucose and reducing the sensitivity of the cells to insulin. The nurse should inform the client that the insulin is needed to control the blood sugar levels while they are on steroid therapy, and that the insulin dose may be adjusted or discontinued when the steroids are tapered or stopped.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: How to check apical heart rate is not a priority education for this client. Apical heart rate is the number of heartbeats per minute that can be heard at the apex of the heart. It can be used to monitor the effect of cardiac medications, such as atenolol or digoxin. This client is taking atenolol, but the nurse can check the client's radial pulse (at the wrist) instead of the apical pulse, unless there is a discrepancy or an irregular rhythm. The nurse should teach the client how to check their radial pulse and report any changes or symptoms.
Choice B reason: Signs and symptoms of hypothyroidism are not a priority education for this client. Hypothyroidism is a condition where the thyroid gland does not produce enough thyroid hormones, which regulate the metabolism and energy of the body. Hypothyroidism can cause symptoms such as fatigue, weight gain, cold intolerance, dry skin, hair loss, and depression. This client is not taking any medication that affects the thyroid function, and there is no evidence of hypothyroidism in the client's history or labs. The nurse should assess the client's thyroid function and teach the client about the signs and symptoms of thyroid disorders.
Choice C reason: Bleeding precautions are a priority education for this client. Bleeding precautions are measures to prevent or minimize bleeding in clients who are at risk of bleeding, such as those who are taking anticoagulants, have low platelets, or have bleeding disorders. This client is taking warfarin, an anticoagulant that increases the risk of bleeding.
Choice D reason: Increasing potassium rich foods in the diet is not a priority education for this client. Potassium is a mineral that helps regulate the fluid balance, nerve impulses, and muscle contractions in the body. Potassium levels can be affected by medications, such as diuretics, ACE inhibitors, or potassium supplements. This client is taking captopril, an ACE inhibitor that can increase the potassium level in the blood. The client's potassium level is normal (4.8 mmol/L), and there is no need to increase the intake of potassium rich foods, such as bananas, oranges, potatoes, tomatoes, or beans. The nurse should monitor the client's potassium level and teach the client about the signs and symptoms of high or low potassium, such as muscle weakness, cramps, irregular heartbeat, or numbness.
Correct Answer is ["0.71"]
Explanation
To calculate how many milliliters (mL) of the reconstituted medication the nurse should administer, we can use the following formula:
Desired dose (in mg) / Stock concentration (in mg/mL) = Volume to administer (in mL)
Given information:
Desired dose of ceftriaxone: 250 mg
Stock concentration after reconstitution: 350 mg/mL
Now let's calculate the volume to administer:
250 mg / 350 mg/mL = 0.7143 mL
Rounding to the nearest hundredth, the nurse should administer 0.71 mL of the reconstituted medication.
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